How to Implement Chiropractic Billing Compliance With Vericle

Your malpractice and general liability insurance policies do not cover audit defense legal fees and costs, leaving you fully exposed to audit liability. Post payment audits occur with increasing frequency and growing gravity of penalties. Systematic and continuous monitoring of billing process is necessary to building a profitable and compliant business. Steps: 1. Document every patient encounter in SOAP notes: If you bill a five region CMT code, make sure your SOAP notes support all five regions. Make sure your notes support any extra-spinal manipulation. 2. Review Compliance Report to identify: 98941 or 98942 on every patient each visit because you are a full spine doctor. Full spine x-rays on each and every patient on the initial exam and then again as a re-check. Billing and coding for cervical, thoracic and lumbar x-rays when meant a full spine performed. 97140 manual therapy in place of a manipulation code because it pays more. Billing for an E/M code on each visit: 99211-5. Billing for all new patients as a 99204 or 99205. Billing for both a spinal and extremity adjustment on each patient. Billing insurance company when the patient wasn't even in the office. If you have seen a patient within the last 3 years, then you must bill the established patient E&M codes. This applies even if the patient has an auto accident, work injury, new insurance carrier, etc. Missing co-payment collection. Separating the diagnostic global fee into professional and technical components. Same day billing for manual therapy, neuromuscular re-education, or massage in the same area as the spinal adjustment. Billing for services rendered beyond maximum therapeutic benefit or for maintenance/preventive care. 99201, 99211, 99241 more than 3 times per month on a single patient. 3. Do not spend less time than stated by the guidelines when doing timed codes. 4. Do not bill for attended electrical stimulation when in fact it was unattended. 5. Do not do ghost billing. 6. Do not advertise free consultation and then bill out a new patient E/M code for the examination. 7. Do not ever "touch up" or otherwise change your notes or chart. Find a billing service vendor, which eliminates this risk once you have signed off. 8. Engage legal expert for continuous review of Vericle compliance reporting. originated by: Yuval, Anonymous, Sondra C, Tom Viren Source: www.wikihow.com